{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:08:07Z","timestamp":1788847687224,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"T\u00dcB\u0130TAK and Izmir Bak\u0131r\u00e7ay University Open Access"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical waste management is a central pillar of the Green Hospital approach, yet evidence on effective strategies and system-level barriers remains fragmented. This systematic review synthesizes direct medical-waste-management evidence together with healthcare-sustainability and transferable waste-system evidence relevant to the Green Hospital framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review in accordance with PRISMA 2020. The review protocol was registered in PROSPERO (CRD420251168204). Six bibliographic databases and one grey-literature source were searched for original empirical, intervention, case-study, modelling, and optimization studies published online between 1 January 2020 and 27 August 2025 that examined medical waste management or provided clearly relevant healthcare-sustainability or transferable waste-system evidence. Two reviewers independently screened records, extracted data, and appraised methodological quality using design-appropriate criteria: the Mixed Methods Appraisal Tool for empirical studies and an adapted model-appraisal framework for modelling, optimization, framework-development, and technology-evaluation studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 21 included studies, 15 provided direct medical-waste-management evidence, five provided healthcare-sustainability or planetary-health contextual evidence, and one provided transferable waste-system evidence. Behavioural compliance, education, or segregation was addressed in 11 studies (52%); workflow or operational optimization in four studies (19%); digital or decision-support systems in five studies (24%); environmental or economic assessment, modelling, circularity, or resource recovery in 10 studies (48%); and systemic or organizational barriers in seven studies (33%). Studies could contribute to more than one synthesis theme; therefore, these categories were not mutually exclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sustainable medical waste management within the Green Hospital framework requires an integrated socio-technical strategy combining behavioural reinforcement, operational improvement, decision-support technologies, environmental and economic assessment, and enabling governance. These findings can be interpreted through a Human Factors and Ergonomics (HFE) lens, although formal HFE interventions were not consistently evaluated in the included studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag103","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:01:31Z","timestamp":1785585691000},"source":"Crossref","is-referenced-by-count":0,"title":["Medical waste management within the Green Hospital approach: a systematic review of direct, contextual, and transferable evidence"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1734-6844","authenticated-orcid":false,"given":"\u0130brahim H","family":"Kayral","sequence":"first","affiliation":[{"name":"Hospitals Quality Coordination, Hacettepe University , Ankara,","place":["T\u00fcrkiye"]},{"name":"Department of Health Management, Faculty of Health Sciences, \u0130zmir Bak\u0131r\u00e7ay University , 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